This is in reply to the story “Accidents of History Created U.S. Health System” on yesterday’s All Things Considered:
I’m a medical historian and find several historical inaccuracies in this report. The first and most egregious is the claim that early twentieth century medicine was “medieval.” This was hardly the case — by this point there were vaccines and treatments for a number of major contagious diseases, including diptheria, syphillis and typhoid fever. Surgery had also made great advances with the advent of sterile surgical procedures.
Yes, “quack” medicines still continued but the FDA (created in 1906) helped to quell some of the most outrageous medical claims.
The report also ignores other major developments in providing affordable medical care, such as the growth of managed care plans. Among the first was Kaiser-Permanente, developed during the Second World War.
To answer other commentors’ questions about why the U.S. doesn’t have a single-payer universal health plan — this is because every attempt to develop one (starting with initiatives during the New Deal era) was fiercely opposed by the American Medical Association and other powerful lobbying groups who called any government intrusion into health care “socialized medicine.” The same argument was made against Medicare and Medicaid in the 1960s.
I ran out of space in the comments section. The authors of this report are clearly lazy and/or misinformed. I also hated the smart-assed way in which they commented on early twentieth century medical care.
Well said. The history of medicine is not my primary field, but pragmatism (and want the desire to do something new) caused me to put together a course on the subject, with a U.S. focus, that I taught in the Spring 09 term. Your statement above jives completely with my reading. Paul Starr’s now old work (STAM, 1982) did the grunt work on showing how the elitist AMA was an obstructionist org with regard to universal health coverage. I would add that medical science as we know it had already taken substantial shape by the 1890s. Yes, post-docs still took their turns in Austria, Germany, and France in the 1890-1910s era, but American medicine and research were on their way to being what they’d become in the interwar era (post-Flexner Report).
I think your larger point is that you, and I too, expect better from mostly high-quality program like *All Things Considered*. Disappointing. – TL